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099 <br />ii,L <br />COUNTY OF LEE <br />BOARDS/COMMISSION APPLICATION <br />The Lee County Board of Commissioners believes that all citizens should have the opportunity to participate <br />in governmental decisions. One way of participating is by serving as a citizen member of one of the county's <br />advisory boards, listed below. If you have an interest in being considered for appointment to one of the <br />boards, indicate by placing a check mark by your interest(s), complete the form below, and mail to the <br />address listed at the bottom of the application. For additional information about our committees or to complete <br />an on-line application, please visit our web site at www.leecountync.gov <br />BOARDS AND COMMISSIONS <br />L] <br />_ Sanford-Lee County Airport Authority _ <br />Jury Commission <br />-Agricultural Advisory Board _ <br />Library Board of Trustees <br />_ Americans with Disabilities Act (ADA) <br />Mid-Carolina Workforce Development Board <br />_ Board of Adjustments (Lee County) _ <br />Parks & Recreation Commission <br />_ Board of Adjustments (Sanford) _ <br />Planning Board (Lee County) <br />_ Board of Equalization & Review _ <br />Planning Board (Sanford) <br />_ Cemetery Board of Trustees _ <br />Rest Home-Nursing Home Advisory Board <br />_ CCCC Board of Trustees _ <br />Senior Services Advisory Board <br />_ Lee County Economic Development Corporation <br />Social Services Board <br />Lee County Fire Advisory Board "i _ <br />Z'- <br />Transportation Advisory Board <br />wee County Environmental Affairs Board- <br />Juvenile Crime Prevention Council <br />- Lee County Board of Health _ <br />Criminal Justice Partnership Advisory Board <br />- Industrial Facilities & Pollution Control Financing Auth. <br />NAME: J 'Shl~ Cep°,t~l n 5 <br />ADDRESS: / D <br />i/S <br />HOME PHONE: <br />PLACE OF EMPLOYMENT: <br />I CERTIFY THAT ALL OF THE INFORMATION CONTAINED IN THIS APPLICATION IS TRUE TO THE <br />BEST OF MY KNOWLEDGE. <br />WORK PHONE: <br />kJ <br />d <br />OCCUPATION: rP_55,!a zl <br />EMAIL: ~i s ~c7i ~5h P ~9 let FAX NO. 1/1- 77Y-33b 'e~ <br />List any experience/qualifications you have relevant to the above board/commission you are interested in. <br />&J,i~~"1~d y,k1,y 1'r`z 'a2(L5 ~~c~;~c:ISo~ far. c~P'" IZ ~EJ /ti' <br />r , <br />- I ~S/aS /iv tt ct <br />4LfIS ~.,tbche m rah<S cJl1e.'7 i =5 <br />invclu <br />DATE: ~ O 2 <br />NOTE: MUST BE A RESIDENT OF LEE COUNTY, AND CAN ONLY SERVE ON TWO (2) BOARDS AT A TIME. <br />Return completed application to: Ms. Gaynell Lee, Clerk to the Board of Commissioners, PO Box 1968, 106 <br />Hillcrest Drive, Sanford, North Carolina, 2773331-1968, or fax to 774-8407 or e-mail to gleea Ieecountync.gov. <br />©(J <br />MAY 1 4 200 <br />